Adolescence is a stage of development
in the lifespan of all humans. The textbook Introduction
to Human Services written by Michelle E. Martin explores the possible roles
of the human service professional in chapter six, Adolescent Services.

Adolescence falls
somewhere between child hood and adulthood and can vary in length depending on
culture, history, social, and regional influences. Each of these influences are
explored, and examples are applied to demonstrate the affects they can have on
the perception and expectations of adolescents throughout generations. Martin
(2018) claimed the expectations and behaviors of adolescents changes through
generations depending on the events occurring in the world around them.

This chapter
within the book, viewed adolescence developmentally while examining the
challenges of changing from a child to an adult.  These developmental challenges are a
combination of factors ranging from family experience, peers, and sociological influences
that cause a spider web of emotions and experiences. Dealing with such complex
issues and emotions can often cause the adolescent to need guidance and therapy
from human services professionals. Some of the issues that professionals may
encounter while working with adolescents include psychological disorders,
disruptive and impulse control, and conduct disorders, which can often be
difficult to decipher between normal versus abnormal teen behavior. Adolescents
may also experience anxiety, depression, eating disorders, self-injury and

Chapter six explored the different practice settings that are available to
teens experiencing these disorders and to possible human service professionals
within this field. Dealing with adolescent disorders require a range of
services from foster or group home settings, boot camps, out patient
counseling, in-patient care facilities, and residential treatment programs that
offer a wide variety of extra-curricular activities. Martin (2018) closed the
chapter with focusing on cultural differences. She explained that race and
ethnicity need to be considered as they can play a large part on not only the
behaviors of some teens, but more importantly, the professional should be aware
of the affects of race and ethnicity on adolescent development.

            The psychological disorder suicide is
increasing, and adolescents are at an elevated risk for suicide. It is the
second leading cause of death among adolescents (Martin, 2018). They are at a
greater risk due to the complex issues surrounding the emotional and
developmental aspects of entering adulthood, yet they lack the reasoning to
understand that harm may come to them. It is important to distinguish between
suicide, suicidal ideation, and the several types of suicidal behaviors. Each
requires a different approach in treatment. The definition of suicide is the
ending of one’s own life. Suicidal ideation involves the thought process of
thinking about the process of ending one’s own life. Knowing the difference
between the two is vital for successful treatment. Trust becomes one of the
most beneficial parts of treatment. It s important for the human service
professional to know when to escalate the need for intervention and when to
continue treatment as a confidant for the adolescent. The fragile line
distinguishing between a suicidal gesture, which is usually a cry for help, and
an actual attempt can be blurry. Most important for the human service
professional is to realize that every suicidal gesture could result in a
successful suicide. The prevention of suicide requires understanding all the
psychosocial risk factors involved. Knowing that there is a significant
difference between the type of adolescent that attempts suicide and the one
that commits suicide can offer insight to some of the behaviors common is a
high-risk adolescent. For example, more males commit suicide and more females
attempt unsuccessful suicides (as cited in Martin, 2018). Suicide completion
often has the forewarning feelings of hopelessness, loneliness, and negative
self-concept followed by feelings of little or no social support and hostility.
Emphasis is given to create a safety plan once an adolescent has been deemed a
suicide risk. A safety plan includes removal of all dangerous objects, weapons,
and medication. Prevention is the most successful treatment of suicide. Suicide
with its epidemic numbers is an important topic for human service professionals
to become experts in recognizing risk factors, assessments, and treatments.
Ongoing education and increased involvement in society including the judicial
system is imperative to combatting this epidemic. Exploring the biological,
cultural, and historical aspects of suicide can offer some insight.

Overall, suicide is the 10th leading cause of death in the
United States. Over 44,000 Americans die by suicide each year. Though there is
no record of attempted suicides each year, it is estimated that there are 25
attempts per every suicide death. Women are 3 times more likely to attempt
suicide, while men are 3 times more likely to be successful. Firearms are
responsible for nearly 50% off all suicides, and men are more likely to use a
firearm to attempt suicide than women (About Suicide, 2016). Why do men die
from suicide more often than women?

Suicide has a long history in human culture. The first
recorded reference in suicide was in Ancient Egyptian literature. Suicide was
generally accepted in Egypt at the time, as death was seen as a passage from
one level of existence to another. It was also seen as a way to avoid excessive
pain, a slow death, or dishonor. In Ancient Rome and Greece, beliefs about
suicide were more nuanced. For the wealthy suicide was motivated for four
reasons: the preservation of honor, the avoidance of excessive pain and
disgrace, bereavement, and patriotism. However, suicide was outlawed for
soldiers, slaves, and persons on trial, and among the lower classes suicide was
frowned upon. Many Greek philosophers; such as Socrates, Plato, and Aristotle,
opposed suicide, believing that humans belonged to the gods. Despite his
opposition, Socrates himself committed suicide.

In Japan, seppuku was a ritual form of disemboweling
oneself. Seppuku was invoked to admit failure, atone for dishonor, or to avoid
humiliation. Samurai, incorporated seppuku into their ethical code known as Bushido, where samurai
were required to follow their fallen feudal lords into the next life, to regain
honor and avoid execution.

Among other cultures, the Vikings considered suicide an
acceptable death for warriors who did not die in battle along with their
compatriots and be allowed into Valhalla. The Goths and Celts favored suicide
over a natural death. Eskimos committed suicide to enter the next life as their
younger selves rather than die old and feeble. In a number of cultures, wives,
servants, and slaves were required to commit suicide when their master died,
from suicide or not. Hindu culture is ambiguous, condemning it but considering
it is justified in special cases, especially when a person has lived a full

Centuries of honor suicides among men have clearly had a
biological component to it. In American culture suicide is not accepted, but
remains prevalent in society. As previously stated, men are 3 times as likely
to commit suicide despite being 3 times less like to attempt it. The reasons
for men committing suicide vary. Mental and physical health issues are
certainly a reason to end one’s life, but the loss of honor or failure still
play a major role.

Researchers have known for years that suicide rates are
higher in cultures that favor individualism over those that emphasize
community. Studies have also shown, as seen in history, that cultures that
overvalue honor are more likely to have suicide rates. These two factors
increase the predictability of suicide in those cultures.

America, it is believed that the mid-west and south have the strongest
historical ties to the honor culture. Practices characteristic of honor states
include family based feuds and dueling between individuals (i.e. gunfights).
Honor states have higher rates of gun ownership, homicides, and divorce. Honor
states historically known to be more sensitive to slights, slurs, and insults
that would often be dealt with through violence. Honor states are also more
likely to have “stand your ground” law. People living in honor states
are more likely to become distressed emotionally when their honor is challenged,
and they often are inclined to use violence to restore honor. This makes people
in honor states to harm others in the restoration of their honor and also more
likely to harm themselves when that are unable to restore that honor (Cultural Values,

Studies have shown the depression rates in these honor
states are higher than other states. They have also shown the men and women is
southern and mid-western states are less likely to seek help from
professionals. Statistics of the number of anti-depressant prescriptions are
significantly lower in these honor states.

Depression is a major factor in a person deciding to
attempt suicide. However, depression does not explain why men are more like to
die from suicide than women do. Women are twice as likely to have depression
compared to men and are two times more likely to have PTSD. Depression and PTSD
go hand in hand, as if you have one, you are very likely to have the other. So,
it is logical to believe that women would have higher suicide rates than men.
As the opposite is true, depression is not the sole precursor to suicide.

There are many reasons why men are 3 times more likely to
succeed killing themselves. They gravitate towards more lethal methods. They
are less likely to seek professional help and more likely to self-medicate. Men
are also more likely to not factor the effects of suicide on others-spouses,
children, family, or friends. The commonality to these factors are rooted in
pride and honor. Psychiatrist theorize that when a man commits suicide, it is
about him, and does not feel the need to share the decision with others.

History has shown us, in numerous cultures throughout time
that suicide is an acceptable form of death for men, particularly in the name
of honor-patriotism, pride, and keeping one’s virtue. Research has shown us
that suicide rates in so called “honor cultures” are significantly
higher than other societies. It stands to reason that men have a biological
predisposition towards using suicide as an answer for extreme failure. However,
as society’s views towards opposition and condemnation of suicide has changed,
particularly in Western Culture, so too will the evolutionary influence of so
called “honor cultures” diminish the need for men to kill themselves
in the name of honor.

considering suicide amongst other disorders plaguing adolescents, race and
ethnicity should be one of the key aspects explored when treatment. Society,
family, and the worldly events affects the development and self- perception of
teens. The disparity in mental health diagnosis is evident in a 2001 study that
showed black males were diagnosed more with conduct disorders versus white
males who were diagnosed with depression. Society has placed a stigma on the
black males as being more prone to violence and therefore, society could have
influenced the medical provider to believe the same. It could be that the
medical provider has failed to understand the cultural differences the black
male has versus the white male (as cited in Martin., 2018). Culture has a
significant impact on the mental health factors, diagnosis and treatment of
adolescents. Mexican Americans are at a higher risk of depression and suicide
than Caucasians. Asians, Hispanics and African Americans are less likely to
receive treatment for depressive disorders for several reasons. The first
reason is affordable mental health treatment and facilities are not as readily
available in lower income neighborhoods. Many ethnic communities have a
negative stigma on mental health and many only receive mental health care once
they have entered the judicial system.

and institutional racism is not the only barrier in receiving mental health
treatment. Poverty, crime infested neighborhoods and family chaos have a
substantial impact as well. African Americans are more likely to be raised in
single parent homes, enter foster care, and experience physical or mental
abuse. Latino adolescents are more likely to conduct in antisocial behavior and
juvenile delinquency, yet they tend to have a stronger family based support
system that offers mental health care and concern. Understanding how each
culture assesses, perceives, and tolerates adolescent behavior is necessary for
the human service professional for affective cultural competent treatment to be

section on Non-Suicidal Self -Injury
Disorder had intriguing facts regarding the ability for adolescents to cope
with deep rooted feelings and emotions. A side affect of depression and
anxiety, Martin (2018), described self-mutilating as easier to mange than the
confusing feelings of depression. The astonishing number of 40 percent of
college students admitted to some degree of self-harming is disturbing. As a forty-year-old
female, military brat, raised mostly in a rural country setting, I never
experienced depression or engaged in self-harm. Although, I was somewhat of the
worst of four teenagers. I engaged in underaged drinking, utilizing marijuana
and skipping school and curfews. My party days were short lived and usually had
tough consequences. My father made us do yard work such as weeding a very large
garden, picking rocks, chopping wood, cutting grass, and clearing brush.

chapter on adolescent services seemed to overlook most of the biological
factors that teenagers experience that could affect their mental health.
Explaining how sleep patterns affect a teen’s mental health and brain function
is vital to understanding and even treating some mental health issues. In a recent
NY Times article, regarding sleep patterns and teenagers, Dr. Wendy Troxel, a
clinical psychologist, senior behaviorist, and social scientist, stated there
is a significant increase of new depression cases arrive when children become teenagers
(2017).  Troxel explained that a great
amount of time and money is spent on programs designed to prevent suicide and
prevent substance abuse and promote safe sex, and she claims they are not
always very successful. She further explained that sleep loss problems are
directly linked to the areas of the brain that control emotional processing and
risk taking. “Sleep problems and behavioral and mental health problems are
linked (Troxel, 2017).  Biological
factors should be added to the chapter, even if brief. Without it, a piece of
the puzzle is missing.



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